heme/onc Flashcards
low reticulocyte count indicates what?
bone marrow failure or diminished hematopoiesis
clinical features of iron deficiency anemia in adolescents
spoon shaped nails and diminished attention and ability to learn
low serum ferritin results in INCREASED/DECREASED transferrin?
increased transferrin and decreased transferrin saturation
what should iron be ingested with?
vitamin C to enhance intestinal iron absorption
anemia characterized by defective synthesis of one of the Hgb Chains?
thalassemia
type of thalasemia prevalent in south east asians?
alpha thalassemia
two alpha glob in genes are deleted and have mild anemia
a thalassemia minor
three alpha glob in genes are deleted - patients have severe anemia at birth .
Hemoglobin H disease
what is hemoglobin Barts ?
seen in three alpha glob in genes deletion
binds oxygen very strongly doesn’t release it to tissue
four alpha glob in genes deleted resulting in only hgb harts formation
fetal hydrops
hepatosplenomegaly
bone marrow hyperplasia
maxillary hyperplasia w/ prominent cheekbones and skull deformities
b thalassemia major
what population has b thalassemia major?
mediterranean background
what is the treatment of beta thalassemia major?
lifelong transfusions and splenectomy
what is a complication of beta thalassemia major? what drug can help it?
hemochromatosis
deferoxamine
Beta thallasemia minor is commonly misdiagnosed as what?
iron deficiency anemia
whmild asymptomatatic anemia w/ hemoglobin level 2-3 below age appropriate norms and target cells and anisocytosis?
beta thalassemia minor
characterized by prussian blue staining resulting from accumulation of iron in mitochondria of RBC precursors in bone marrow ?
sideroblastic anemia
macrocytic megaloblastic anemias are characterized with MCV > ?
95
what are two major causes of macrocytic megaloblastic anemia?
folic acid and vitamin B 12 deficiency
vitamin b 12 must first combine with what?
instrinsic factor secreted by gastric parietal cells
where is vitamin b 12 absorbed?
terminal ileum
what is up w/ tongues in vitamin b 12 deficiency?
smooth red tongue and neurology manifestations
what is the treatment of vitamin b 12 def?
monthly IM vitamin b 12 injections
spectrin defect causing RBC membrane instability autosomal dominant?
hereditary spherocytosis
splenomegaly, pigmentary gallstones, aplastic crises and high retic count ?
hereditary spherocytosis
what studies are used for hereditary spherocytosis ?
osmotic fragility studies
tx of hereditary spherocytosis
transfusions and splenectomy after 5 years of age
what are 2 enzyme deficiencies of RBS?
pyruvate kinase and G6PD
what does blood smear show in G6PD deficiency?
bite cells and hemighosts/ heinz bodies
what are some triggers of hemolysis in G6PD
fava beans, infection, drugs
positive direect coombs test indicates?
autoimuno hemolytic anemia
tx for autoimmune hemolytic anemia
corticosteroids and transufision
occurs when mom is Rh negative has Rh positive baby and forms Rh antibodies and subsequent pregnancies result in hemolysis of Rh positive babies? with a strongly positive coombs test
Rh hemolytic disease
this type of alloimmune hemolytic anemia can occur in the first pregnancy when mom is blood group O and fetus is blood group A, B, or AB? Moms antibodies are passed downy o baby causing hemolysis ?
ABO hemolytic disease
what is management for alloimmune hemolytic anemia?
phototherapy and exchange transfusion